26 Feb Diabetes and Depression: Cognitive Therapy Improved Both
MedicalResearch.com Interview with:
Steven A. Safren, Ph.D., ABPP
Professor of Psychology, Harvard Medical School
Director, Behavioral Medicine, Department of Psychiatry
Massachusetts General Hospital,
Boston, MA 02114
MedicalResearch.com: What are the main findings of the study?
Dr. Safren: The main findings of the study are that, in patients with uncontrolled type 2 diabetes and depression, a type of psychological treatment, cognitive behavioral therapy (CBT) that addressed both self-care and depression, resulted in improvements in both depressed mood, self-care, and glucose control. This was a randomized controlled trial, and this cognitive-behavioral treatment worked better than lifestyle adherence and nutrition counseling alone; and the effects were sustained over 8 months.
MedicalResearch.com: Were any of the findings unexpected?
Dr. Safren: The only unexpected finding was that for the depression outcome, although patients who got the CBT intervention improved over and above those in the control group at the first follow-up, and their gains were maintained over follow up, the difference between the two groups in depression disappeared at the 8 and 12 month follow up. We think this is because of the design issue where we referred anyone who needed it for outside treatment of depression at the follow-up visits.
MedicalResearch.com: What should clinicians and patients take away from your report?
Dr. Safren: That combining counseling for adherence with an evidenced based (cognitive behavioral) psychosocial treatment for depression can result in mental health, self-care, and biomedical improvments in health for patients with uncontrolled type 2 diabetes and depression.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Safren: Test the cost-effectiveness of this approach with respect to decreased health care costs as a result of treating depression and improving self-care in patients with chronic medical illness and comorbid mental health problems.
Citation:
Safren SA1, Gonzalez JS, Wexler DJ, Psaros C, Delahanty LM, Blashill AJ, Margolina AI, Cagliero E.
Diabetes Care. 2014 Mar;37(3):625-33. doi: 10.2337/dc13-0816. Epub 2013 Oct 29.
Last Updated on February 26, 2014 by Marie Benz MD FAAD